National Birth Equity Collaborative’s Louisiana 2021 Legislative Session Report

Legislative session 2021 was one for the books. As NBEC’s second year engaging in Louisiana’s legislative session and a year following the start of the pandemic, we were able to make great strides in improving maternal health across Louisiana.

Legislative Developments

For almost a year NBEC, and a few partner organizations, led efforts for the Mama+ Health Policy Agenda (Mama+). The Mama+ is a state and local level policy initiative, loosely based on the Black Maternal Health Momnibus Act of 2020 (the Momnibus), to address the Black Maternal Health Crisis in Louisiana and New Orleans. Like the Momnibus, we created multiple titles to categorize areas that impact the health and birth outcomes of Black birthing people in Louisiana. Titles included recommendations from state-led initiatives formed by previous legislation, like the maternal mortality review committee and the pregnancy-associated mortality review committee. Our 8 titles are below.

● Address social determinants of health that affect maternal health outcomes.

● Diversify and increase the perinatal workforce.

● Promote extended Medicaid to one year postpartum for maternal health.

● Improve maternal healthcare and support for incarcerated birthing people.

● Invest in maternal mental health care and substance use disorder treatments.

● Improve telehealth and other digital tools to provide maternal health care to underserved areas.

● Increase payment for group prenatal care.

● Establish a maternal child health (MCH) position on the local level.

The titles span state level and local level policy recommendations, with some specific to only local level activity. State level policy efforts will be highlighted as we discuss the 2021 Regular Legislative Session.

Reflections

Coming off the pandemic and a significantly modified 2020 regular session, we did not know what to expect. With that in mind, knowing we were entering into a fiscal session and facing budget restraints, we prepared for an uphill battle. In preparation, we met with legislators who were identified as maternal health champions and the Mama+ group began building our advocacy base using Action Network.

Overall, legislative session was successful for the Mama+ initiative. Many of the bills that NBEC helped develop and/or advocate for had favorable outcomes. However, there were some pieces of legislation that did not pan out exactly as we desired. Those pieces of legislation can be used as lessons and/or stepping stones for our ultimate legislative goals. Figure 1 identifies those bills we directly worked on or supported in our policy initiative.

In addition to the Mama+ Health Policy Agenda, NBEC worked on other important state level initiatives during legislative session. The first week of session was also Black Maternal Health Week. Due to the overlap, we participated in Black Maternal Health Advocacy Day and worked with the Governor’s office on the Black Maternal Health Week Proclamation. Black Maternal Health Advocacy Day highlighted the importance of the various bills outlined in Figure 1 as they relate to Black Maternal Health. The primary audience for that event was state legislators. Bill sponsors also participated in the event.

Strengths and Challenges

There were a few strengths and challenges that were identified throughout the legislative session. Our primary strength was the Mama+ Health Policy Agenda workgroup and active participation in other coalitions focused on advancing birth/health equity. Members of the workgroup were able to support the bills through connecting with legislators, sending information to their organizational supporters, and submitting testimonies. Coalitions were also integral in strategizing and identifying possible opposition. Another strength was we began building our advocacy base. We used Action Network to send out alerts and advocacy tasks to various supporters of organizations represented in the Mama+ workgroup. Social media was utilized as a tool to strengthen outreach and grow advocacy base.

Key challenges with legislative session were bill amendments and legislators’ unfamiliarity with key maternal and child health (MCH) terminology and/or bill connection to MCH. Although we experienced multiple successes this session, a couple of bills were amended removing pieces important to our ultimate goal. In an effort to take steps despite the pushback, we accepted the changes with the intention to continue fighting for the pieces that were removed in future sessions. It is important that amendments are closely examined to ensure legislation will not have any unintended consequences on the communities we work for. Gaps in MCH language and connection to policy were another challenge. Legislators were not familiar with terms or how bills would improve MCH so in some instances, opposition presumably came from a knowledge gap.

Next Steps

In preparation for the 2022 Regular Session, we plan to improve in two areas — education and advocacy building. As identified in our challenges, legislators are not extremely familiar with key MCH concepts or how most bills impact maternal and child health in Louisiana. To combat this problem, we will connect with legislators and legislative caucuses for outreach. In that communication, it is our goal to better familiarize legislators with MCH problems and terminology. We will also continue to participate in advocacy building through strengthening our advocacy base. This step includes informing the public of MCH problems and how to engage in the legislative process.

All in all, this session had great wins but even greater lessons. We plan to keep each at the forefront of our minds as we continue to better the MCH landscape for Black birthing people and families in Louisiana.

Article written by Kiley Mayfield. She is a Birth Equity Policy Analyst at the National Birth Equity.